Back in the ward, Su Yun stood beside the patient and stared at the ECG monitor.
"How is it?"
"Not optimistic," Su Yun said. "IABP can't give the heart enough rest."
Zhao Yunlong placed the signed document into the medical record folder. Su Yun saw it and let out a long sigh of relief.
"Chief Lin will be here soon. Boss, what are you going to do?" Su Yun asked.
"I'll think about it." Zheng Ren did not answer Su Yun's question directly. Instead, he inserted the patient's MRI scan into the radiographic film viewer.
Moyamoya disease is a cerebrovascular disease of unknown etiology, characterized by progressive stenosis or occlusion of bilateral internal carotid arteries, anterior cerebral artery and middle cerebral artery, and secondary formation of abnormal vascular network of skull base.
Since the abnormal vascular network at the base of the skull resembled "smoke" on cerebral angiography, it was called "moyamoya disease".
The MRI clearly showed the pathological changes of the blood vessels in the patient's brain. Old cerebral infarction and localized brain atrophy were most obvious at the bottom of the frontal lobe and temporal lobe. The abnormal vascular network at the bottom of the skull was honeycombed or reticular low-signal vessels due to the flow emptying effect.
It was more obvious moyamoya disease. Zheng Ren looked at the mass of proliferating blood vessels that looked like smoke exhaled after smoking and was a little worried.
Forget it, no matter what the patient's family members choose, it was better to go to the System's operating theater and try.
Although the chances of saving the patient's life were slim, he did not want to give up as long as there was a glimmer of hope.
If he could save the patient in the System's operating theater, he would give it a try even if it meant taking a huge risk.
The System was simply too hateful. He was so seriously ill, yet he didn't issue a mission?
Zheng Ren habitually placed his left hand under his right armpit and rested his chin on his right hand as he looked at the patient's MRI image.
After making his decision, he entered the System Space.
He hesitated when he clicked to purchase the surgical training time.
If the patient's family refused to accept the surgery no matter what, the surgical training time he bought would be wasted. More importantly, this was not a general surgery, but a neurosurgery that he had never performed before!
At the very least, he would have to "waste" a Grandmaster-level skill book.
A while ago, he had been doing quests, and the rewards he had accumulated were three Master Alchemist Skill Books. At that time, he thought he would use it for a long time, but he did not expect to use the last one so soon.
He was about to go to Europe and face the ancient, mysterious vampire family …
However, if the patient's family agreed, but he could not solve this problem through surgery, what should he do?
After hesitating for less than a second, Zheng Ren made his decision.
He chose to purchase the surgery training time and used the last Grandmaster-level skill book.
Neurosurgery was the most sophisticated of all surgeries.
When Zheng Ren was in school, he had heard from his teacher that in the past, when the conditions were not good, drillers would be placed after drilling holes for drainage. When the drainage bar was not smooth, it was customary to apply negative pressure to discharge the redundant drainage.
However, this process of exerting negative pressure could cause several milliliters of brain tissue to be sucked out.
As a result, because of the loss of these brain tissues, the patient would be unable to speak, suffer from hemiplegia, lack of walking ability, and other symptoms after surgery.
That was why he had always avoided neurosurgery. To him, it was a very difficult surgical method.
But today, there was no other way. No matter what, he had to try.
'After all, it's a Grandmaster-level skill. There should be no problem,' Zheng Ren thought to himself.
First, the superficial temporal artery and the middle cerebral artery were successfully anastomosed to treat cerebral ischemia. Since then, many countries had carried out this kind of surgery.
Zheng Ren did not believe that his surgical skills were not comparable to the level of surgery in the 1960s and 1970s.
After entering the operating theater, Zheng Ren saw the simulation mannequin lying on the operating table.
He was not in a hurry to perform the surgery. Instead, he first observed the position of the simulation mannequin. After all, it was an unfamiliar neurosurgery. No matter how cautious he was, it was necessary.
The System used a tracheal intubation method in the supine position of the patient and gave intravenous drugs at the same time. It used a radial artery puncture to connect to invasive arterial pressure monitoring. It was convenient to observe the dynamic changes of blood pressure during the surgery in time and provide a reliable basis for controlling and regulating blood pressure.
It could monitor arterial pressure at any time and place. It seemed that the System was also very cautious. Zheng Ren made a judgment.
The simulation mannequin's head was tilted to the healthy side, and a microscope was placed in the operating area.
Zheng Ren glanced at it. It was Zeiss'! He was a little excited.
According to Su Yun's description, Zeiss's microscope could help him avoid the problem of underdeveloped vestibular nerves as much as possible.
Otherwise, every time he finished a microsurgery, it would be as uncomfortable as riding a roller coaster after the surgery.
Zheng Ren hated roller coasters!
It should be okay. Let's start the surgery. Thinking of this, Zheng Ren noticed that the simulation mannequin had already prepared the skin.
The skin preparation in neurosurgery was to shave the head. An experienced nurse would shave quickly and steadily. An inexperienced one would either leave some hair or cut the scalp.
Zheng Ren took a look. The System was an experienced nurse. The skin preparation was almost perfect.
Routine brain surgery disinfection, a sterile dressing, a subcutaneous injection of anesthetic around the edge of the incision, a pterygoid approach to cut the scalp and subcutaneous tissue, and a bipolar hemostasis.
The blood supply to the scalp was simply too rich. Although Zheng Ren had a Legend-level surgical skill, he was not proficient in it because he had been spoiled by the System. He wasted a considerable amount of time on this step.
Then, Zheng Ren began to dissociate the superficial temporal artery. He cut open the top of the temporal muscle and covered it with normal saline gauze to protect it.
He used an AO.
He removed the skull bone flap with a milling knife, cut open the dura mater, and used the microscope to dissociate the middle cerebral artery and its branches.
The microscope was not bad. It was 40x. Zheng Ren was very careful with every step.
However, it was his first time doing it. He failed 12 times in this step.
The surgery failed, and the simulation mannequin died …
The surgery failed, and the simulation mannequin was paralyzed …
Zheng Ren was almost numb when he read such notifications.
However, he had experience in microsurgery after all. The surgical range of neurosurgery was narrow, and the movements under the microscope were as gentle as possible. He quickly mastered it.
On the 13th surgical training, Zheng Ren finally completed the dissociation step perfectly.
He selected a suitable recipient and anastomosed the broken end of the superficial temporal artery with the middle cerebral artery.
/0ploene
The suture was done under the line microscope. During the suture process, a soft needle with heparin saline was used to repeatedly wash the surgical field and lumen to prevent thrombosis.
After the anastomosis was completed, the surgical field was thoroughly washed, the dura mater was turned over, the surgical items were counted, the inner layer of the temporal muscle was pasted to the surface of the meninges and fixed with the dura mater at the edge of the bone.
The bone flap was placed back.
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The scalp was sutured with absorbable thread, and the iodine gauze was covered with the head.
The surgical completion rate was 50%!
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